Elevated AST/ALT levels

[BklynMan]

I just got back my blood work. The Lipid Panel was good.  159-Chol., 87 LDL, 57 HDL, 73 Triglycerides. I have been taking Niaspan 1000mg/2x/day for at least five years. I had an angioplasty in 1999. Previously my cholesterol was high and my father died of a heart attack.

I take a wide range of supplements from Multi-Vitamins, Folic Acid, Lysine, Arginine, Vtiamin C. I started a new trype of Arginine just prior to the blood test, 1000mg in a tablet form.

My liver panel showed 126 ALT, 162 AST, 118 Alkaline Phosphate, 1.6 Bilirubin. All liver proteins were normal. My last test in 2006 showed, 38 ALT, 41 AST, 139 Alkaline Phosphate, 1.5 Bilirubin. All proteins wree normal.

We did have two sets of visitors that we took winery tours with in the last week.

Any ideas? I'm pretty nervous about this.  

[BklynMan]

Thanks for the reply. I'm 56 and used to give blood a lot before they were that stingent on their safety procedures. Other than that nothing I can think of. Was divorced for several years and had several sexual partners but thats about it. The numbers hopped up on my last test, the most prior test was a little over a year ago and they were normal. Maybe thats why the doctor feels it may be the Niaspan maybe combined with alcohol and ibuprofin that I was taking for knee pain. I giess its all a balancing act. They tell you to take something for one condition and it screws up something else.

[Jakied]

Do you have a risk factor for hep b or c?  Blood transfusion, organ transplant, risky sex, Idu?  Your alt/ast are definitely raised but not out of sight.  I have seen alt levels in the thousands.  

IF you have a risk factor for hep, get tested.

[BklynMan]

Bill- Thanks for your comments. My doctor told me to stop taking the Niaspan and get retested in 6 weeks. He doesn't appear to be too concerned. In the meantime, I'll skip any drinking and I think I may start taking some milk thistle.

[Bill1954]

Hi there;

Just so you know, no doctors here; mostly patients with Hepatitis C. Your liver enzymes are certainly hopped up; that usually indicates some degree of damage/inflammation is occurring.

First, take a good look at *all* your current meds, including any OTC or alternative drugs. Check them for hepatatoxicity; as you‘re probably aware, even acetaminophen can play havoc with the liver if taken in excess.

Also, keep in mind that vigorous exercise can raise liver enzymes, as well as some cardiac events. Run a marathon the day before the labs were drawn?

Also, check any archived records you might have available to see if any trend can be established- i.e, slow increases over time.

While your liver enzymes are elevated, they are only about four or five times reference range, so it doesn’t appear that you’re going through decompensation. The ratio is interesting as well; an AST over ALT is generally more indicative of alcoholic liver disease than viral hepatitis. This brings us to alcohol; this is probably the number one reason for elevated liver enzymes. If you have been drinking more than moderately, or heavily a few days before testing, this could explain things as well.

Finally yet importantly, what does your doctor have to say? Check with him, and let us know things progress.

Take care,

Bill